School Age Program
CCL 355 Program Director’s Annual Report SAP form is to be submitted to the Kansas Department of Health and Environment (KDHE)(additional documentation is required).
Application Packet Forms
- CCL 303 Closure Notification (PDF)
- CCL 351 SAP Application (PDF)
- CCL 351a Instructions SAP (PDF)
- CCL 351b Application Checklist SAP (PDF)
- CCL 355 Program Director's Annual Report SAP (PDF)
- CCL 362 New High Risk Activity Form (PDF)
- CCL 402 Orientation Checklist for School Age Program (PDF)
- CCL 002 Background and Registry Check (PDF)
- CCL 002 Background and Registry Check Spanish (PDF)
- CCL 002a SAP Affiliate Roles (PDF)
- CCL 002a SAP Affiliate Roles Spanish (PDF)
- CCL 028a Critical Incident Report (PDF)
- Critical Incident Reporting FAQs (PDF)
- Corrective Action Plan Provider Instructions (PDF)
- Corrective Action Plan Template (PDF)
Supplemental Forms in Application Packet
- CCL 002 Background and Registry Check (PDF)
- CCL 002 Background and Registry Check Spanish (PDF)
- CCL 002a SAP Affiliate Roles (PDF)
- CCL 002a SAP Affiliate Roles Spanish(PDF)
- CCL 010 Authorization for Emergency Medical Care (PDF)
- CCL 010 Authorization for Emergency Medical Care Spanish (PDF)
- CCL 026 Short-Term Medication Authorization (PDF)
- CCL 026 Short-Term Medication Authorization Spanish (PDF)
- CCL 027 Long-Term Medication Authorization (PDF)
- CCL 027 Long-Term Medication Authorization Spanish (PDF)
- CCL 357 Health Status for 14 years and Older (PDF)
- CCL 358 Child Health History (PDF)
- CCL 359 Authorization for Self-Administration (PDF)
- CCL.034 Off Premises Permission Individual (PDF)
- CCL.035 Off Premises Permission Group Trips (PDF)
- CCL.037 Guidelines for Exclusion of children who are ill (PDF)
- CCL 356 Application for Program Director Approval (PDF)
- CCL 356 Application for Program Director Approval Spanish (PDF)
- CCL 203 School Age Programs Self-Audit Survey Tool (PDF)
Supplemental Forms not in Application Packet
Informational Documents
- Child Care Initial and Annual Surveys (PDF)
- Child Care Initial and Annual Surveys Spanish (PDF)
- Child Care Complaint Survey Information (PDF)
- Child Care Complaint Survey Information Spanish (PDF)
- CCL 006 Reporting Suspected Abuse and Neglect (PDF)
- CCL 006 Reporting Suspected Abuse and Neglect Spanish (PDF)
- CCL 008 Licensing of Child Care (PDF)
- CCL 036 Selecting Child Care Guide for Parents (PDF)
- CCL.037 Guidelines for Exclusion of children who are ill (PDF)